Although death from colorectal cancer (CRC) is largely preventable, it remains the second-leading cause of cancer-related deaths in the United States. Incidence and mortality can be reduced by screening; however, less than 50% of eligible adults are adherent to screening guidelines. Rates of adherence are even smaller In Appalachia. West Virginia's rates of CRC screening with sigmoidoscopy or colonoscopy (2004) were lower (46.6%) than the US average (53.4%). The goal of this pilot study is to design and test the feasibility of an intervention directed by community pharmacists to increase patient knowledge and improve patient readiness to seek CRC screening, especially in medically underserved communities. The intervention will utilize community-based pharmacists to educate and counsel patients 50 years old and older at average risk about CRC screening. The limited availability of primary care clinicians, especially in rural Appalachia, encourages testing unique interdisciplinary approaches to patient education and outreach. Community pharmacists are viewed as members of the primary care team in clinics and communities throughout Appalachia. The primary outcome of the intervention is to move patients along the stages of change continuum, as measured by: patient knowledge of CRC risk and the accepted screening modalities; patient intention to discussion screening with their primary care provider; patient intention to obtain CRC screening, and other indicators of stage progression. This pilot study is consistent with Phase II of the National Cancer Institute Community Networks Program because it encompasses key principles of community-based participatory research: it builds on the existing strengths and resources within rural communities, in particular the skills and expertise of community pharmacists and the trust that exists between pharmacists and their patients; and involves community pharmacists, members of the Appalachia Community Cancer Network and lay community members in its development and implementation. The interdisciplinary research team is well positioned to conduct this research because of its links with pharmacists and community organizations, and its expertise in cancer prevention and control interventions. The results of this study are expected to inform an R03 or R21 application, which could lead to a randomized controlled trial (R01) testing the efficacy of an interdisciplinary approach involving non-physician primary care providers to increase CRC screening. [unreadable] [unreadable] [unreadable] [unreadable]